Therapeutics - HIV Combined

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kyleannkelsey
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289594
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Therapeutics - HIV Combined
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2014-11-18 23:41:30
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Therapeutics HIV
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Therapeutics - HIV
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Therapeutics - HIV
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  1. What type of drug is Emtricitabine-Emtriva?
    NRTI
  2. What type of drug is Abacavir+Lamivudine - Epzicom?
    NRTI
  3. What type of drug is Emtricitabine+Tenofovir DF – Truvada?
    NRTI
  4. What type of drug is Lamivudine+Zidovudine – Combivir?
    NRTI
  5. What type of drug is Nevirapine – Viramune?
    NNRTI
  6. What type of drug is Delavirine – Rescriptor?
    NNRTI
  7. What type of drug is Maraviroc?
    CCR5 co-receptor antagonist (Fusion Inhibitor)
  8. What are the Fusion inhibitors?
    Maraviroc and Enfuvirtide
  9. What is the generic name for Fuzeon?
    Enfuvirtide
  10. What is the brand name for Enfuvirtide?
    Fuzeon
  11. What is the brand name for Maraviroc?
    Selzentry
  12. What is the generic name for Selzentry?
    Maraviroc
  13. What type of drug is Efavirenz – Sustiva?
    NNRTI
  14. What type of drug is Atripla (tenofovir + emtricitabine + efavirenz)?
    NNRTI
  15. What type of drug is Etravirine – Intelence?
    NNRTI
  16. What type of drug is Rilpivirine – Edurant?
    NNRTI
  17. What type of drug is Complera (tenofovir + emtricitabine +rilpivirine)?
    NNRTI
  18. Atazanavir has better or worse Bioavailability with food?
    Better
  19. How is Atazanavir metabolized?
    Metabolized by P4503A inhibitor/substrate
  20. What are the SE for Atanazivir?
    hyperbilirubinemia – (jaundice); HA; rash; GI symptoms; 1st degree A-V block; hyperglycemia; fat maldistribution
  21. What is the preferred boosted-PI by DHHS guidelines?
    Daranavir
  22. Daranavir will be used along with ___________.
    ritonavir
  23. Daranavir should be given with or without food?
    With
  24. Daranavir can be used with what type of HIV virus?
    Used for wild-type and PI-resistant virus
  25. What are the SE of Daranavir?
    • Hepatitis; S-J syndrome; TEN; HA (15%); N (18%); diarrhea (20%)
    • Contains sulfa moiety – rash
  26. How is Daranavir metabolized?
    by CYP3A
  27. Fosamprevavir is effected by food in what way?
    No food effect
  28. What CYP interactions does Fosamprevavir have?
    CYP4503A inducer/inhibitor/substrate
  29. What are the SE of Fosamprevavir?
    • rash 19% S-J syndrome; headache; hyperlipid; fat maldistribution;
    • Sulfa moiety – rash
  30. Indinavir has what CYP interaction?
    P4503A inhibitor
  31. Indinavir has what SE?
    Nephrolithiasis (kidney stones); GI intol; hyperbilirubinemia; hyperlipid; hyperglycemia; fat maldistribution; headache; blurred vision; rash; red. PLTs
  32. Lopinavir+Ritonavir should be taken with or without food?
    Mod. Fat meal elevates AUC 48% and 80% (caps/solution)
  33. What CYP effects does Lopinavir+Ritonavir have?
    P4503A inhibitor
  34. What SE does Lopinavir+Ritonavir have?
    GI intol; hyperlipid; elevated LFTs; hyperglycemia; fat maldistribution
  35. Nelfinavir should be taken with or without meals?
    Concs. Increase 2-3 fold – take w/meals
  36. Nelfinavir has what CYP effects?
    P4503A inhibitor/substrate
  37. Nelfinavir has what SE?
    diarrhea; hyperlipid; hyperglycemia; fat maldistribution; elevated LFTs
  38. Tipranavir is not recommended in what group and why
    • Not recommended in tx-naïve pts.
    • Use for People to fall back on if they develop resistance
  39. What are the SE of Tipranavir?
    • Hepatic impairment
    • Intracranial hemorrhage
    • Rash
    • GI effects – N, V, D
  40. PIs have what effect on Azoles?
    Increase Azole concentrations
  41. PIs have what effect on Clarithromycin?
    Increase Clarithromycin concentrations
  42. PIs have what effect on PPIs?
    Decrease PPI concentrations (may be equally effective though)
  43. PIs have what effect on Opioids?
    Increase opioid levels
  44. PIs have what effect on antiarrhythmics?
    Increase antiarrhythmic levels
  45. PIs have what effect on anticonvulsants?
    Reduce concentration of anticonvulsants and PI
  46. What other drugs are CI with PIs?
    • Rifampin
    • Rifabutin
    • Benzodiazapines
  47. What effect do PIs have on Warfarin?
    Increase levels
  48. What effect do PIs have on statins?
    Increase levels
  49. What are the Non-Nucleoside Reverse transcriptase inhibitors?
    • Nevirapine - Viramune
    • Delavirine - Rescriptor
    • Efavirenz – Sustiva
    • Atripla (tenofovir + emtricitabine + efavirenz)
    • Etravirine - Intelence
    • Rilpivirine – Edurant
    • Complera (tenofovir + emtricitabine +rilpivirine)
  50. What is the brand name for Nevirapine?
    Viramune
  51. What is the brand name for Delavirine ?
    Rescriptor
  52. What is the brand name for Efavirenz?
    Sustiva
  53. What is the brand name for tenofovir + emtricitabine + efavirenz?
    Atripla
  54. What is the brand name for Etravirine?
    Intelence
  55. What is the brand name for Rilpivirine?
    Edurant
  56. What is the brand name for tenofovir + emtricitabine +rilpivirine?
    Complera
  57. What is the generic name for Viramune?
    Nevirapine
  58. What is the generic name for Rescriptor?
    Delavirine
  59. What is the generic name for Sustiva?
    Efavirenz
  60. What is the generic name for Atripla?
    Tenofovir + emtricitabine + efavirenz
  61. What is the generic name for Intelence?
    Etravirine
  62. What is the generic name for Edurant?
    Rilpivirine
  63. What is the generic name for Complera?
    Tenofovir + emtricitabine +rilpivirine
  64. Delavirdine should be separated by 1 hr from what other drugs?
    Didanosine or antacids
  65. How is Delavirdine effected by food?
    No food effect
  66. How is Delavirdine metabolized?
    By P4503A (inhibitor); 51% excreted in urine (as metabolites)
  67. What are the SE of Delavirdine?
    rash; elevated LFTs; headache
  68. Use of DLV is not recommended due to:
    High pill burden, dose frequency, SE and DDIs
  69. Efavirenz has good or bad bioavailability?
    Poor 42%
  70. How is Efavirenz metabolized?
    By P4503A (mixed inducer/inhibitor)
  71. What are the SE of Efavirenz?
    • Rash; CNS symptoms (52%) = Suicide ideation; elevated LFTs; false + cannabinoid test; teratogenic in monkeys (try not to use in 1st trimester)
    • Probably shouldn’t use with schizophrenia or depression
  72. Is Efavirenz used as an initial therapy?
    Yes, commonly
  73. Nevirapine has good or bad bioavailability?
    Good 90%
  74. What is Nevirapine metabolized by?
    P4503A (inducer)
  75. What are the SE of Nevirapine?
    Rash (37%); S-J syndrome; hepatitis; fatal hepatic necrosis particularly in women (pregnancy)
  76. Entravirine has in vitro activity against what?
    NNRTI-resistant strains
  77. Entravirine should be taken with or without food?
    • With
    • CYP450 3A4 inducer
    • Toxicity: rash 9%; S-J syndrome; nausea 13%
  78. Is Entravirine used initially?
    Not usually, usually just used in NNRTI-resistant strains
  79. Rilpiverine is usually combined with what other drugs?
    Tenofovir + emtricitabine
  80. What group of patients is Rilpiverine usually used in?
    • Ttreatment naïve pts
    • VL < 100,000
  81. What are the SE of Rilpiverine?
    Depression (4%), insominia, headache (3%), and rash (3%)
  82. What drug requires a viral oad of < 100,000?
    Rilpiverine
  83. Cross resistance to efavirenz, etravirine, and/or nevirapine is likely after development of resistance to _________.
    rilpivirine
  84. Cross resistance ___________,___________ and/or ______________is likely after development of resistance to rilpivirine.
    to efavirenz, etravirine, and/or nevirapine
  85. NNRTIs have what effect on Azole antifungals?
    • Decrease in Azole conc.
    • Increase in NNRTI conc.
  86. What NNRTIs affects Clarithromycin and what effect do they have?
    • Rilpivirine
    • Etravirine
    • Increase in both Clarithromycin and NNTRI concentration
  87. What NNRTIs affects PPIs and what effect do they have?
    • Rilpivirine
    • Decrease PPI levels (CI)
  88. What NNRTIs affects Opioids and what effect do they have?
    • Decrease Opioid levels
    • Efavirenz
    • Rilpivirine
  89. Anticonvulsants are CI with what NNRTIs?
    Etravirine
  90. Rifampin/Rifabutin are CI with what NNRTIs?
    • Efavirenz
    • Etravirine
  91. Benzodiazapines are CI with what NNRTIs?
    • Efavirenz
    • Etravirine
  92. What NNRTIs affects Warfarin and what effect do they have?
    • Increase Warfarin levels
    • Efavirenz
    • Etravirine
  93. Enfuvirtide is used at what point in treatment?
    • Usually all other treatments exhausted
    • Low CD4 cells
  94. How is Enfuvirtide used for the treatment of HIV-1?
    In combination with other antiretroviral agents in treatment-experienced patients despite ongoing antiretroviral therapy
  95. What is the MOA of Enfuvirtide?
    Interferes with the entry of HIV-1 into cells by inhibiting fusion of viral and cellular membranes
  96. Maraviroc is a CCR5 co-receptor antagonist, what is the MOA of this drug class?
    Fusion inhibitor
  97. What is Maraviroc indicated for?
    • Combination antiretroviral treatment in adults
    • Only for CCR5-tropic HIV-1 detectable disease
    • Test to determine if you have CCR5-tropic virus
    • For use in patients who have evidence of viral replication
    • HIV-1 strains resistant to other antiretroviral agents
  98. What is the MOA of Maraviroc?
    • Binds to human CCR5 on cell membrane
    • Prevents interaction between HIV-1 gp120 and CCR5
    • Blocks entry of HIV-1 into human cells
  99. Pharmacokinetics:
    23% FF* - 100 mg dose; 33% FF* - 300 mg dose
  100. What are the side effects of Maraviroc?
    Abdominal pain, cough, dizziness, rash, hepatotoxicity, orthostatic hypotension
  101. Should you take a lower or higher dose if you give Maraviroc with a strong CYP3A inhibitor?
    Lower
  102. Should you take a lower or higher dose if you give Maraviroc with a NRTIs, tipranavir/ritonavir, Nevirapine, Enfuvirtide?
    Moderate= normal
  103. Should you take a lower or higher dose if you give Maraviroc with given with CYP3A inducers (efavirenz, rifampin, etc.)?
    Higher
  104. What is the bioavailability of Maraviroc associated with?
    Dose
  105. What are the integrase inhibitors?
    • Raltegravir – Isentress
    • Dolutegravir – Tivicay
    • Dolutegravir abacavir/lamivudine - Triumeq
    • Elvitegravir – Stribild (quad pill)
    • Cobicistat – Tybost
    • Elvitegravir – Vitekta
  106. What is the brand name for Raltegravir?
    Isentress
  107. What is the brand name for Dolutegravir?
    Tivicay
  108. What is the brand name for Dolutegravir abacavir/lamivudine?
    Triumeq
  109. What is the brand name for Elvitegravir?
    Stribild (quad pill)
  110. What is the brand name for Cobicistat?
    Tybost
  111. What is the brand name for Elvitegravir?
    Vitekta
  112. What is the generic name for Isentress ?
    Raltegravir –
  113. What is the generic name for Tivicay?
    Dolutegravir
  114. What is the generic name for Triumeq?
    Dolutegravir abacavir/lamivudine
  115. What is the generic name for Stribild (quad pill)?
    Elvitegravir
  116. What is the generic name for Tybost ?
    Cobicistat
  117. What is the generic name for Vitekta?
    Elvitegravir
  118. What is the MOA of Raltegravir?
    • Integrase inhibitor – prevent insertion of HIV DNA into the human DNA genome
    • Block the formation of HIV-1 provirus
  119. What group of patients is Raltegravir used in?
    Treatment of HIV for tx-naïve and drug resistant pts with HAART
  120. Should Raltegravir be administered without regard to food?
    Either
  121. How long does it take to reach steady-state after beginning Raltegravir?
    Achieved within 2 days of dosing
  122. How is Raltegravir metabolized?
    By UGT1A1 via glucuronidation
  123. What are the side effects of Raltegravir?
    • Skin rash evolve to Stevens-Johnsons syndrome
    • Elevated CPKs
  124. What is the dose of Dolutegravir (Tivicay)?
    • 50 mg QD
    • Take BID if using enzyme inducers like: efavirenz, boosted fosamprenavir, tipranavir, or rifampin
    • Treatment-experienced patient – 50 mg BID
  125. Should you give Dolutegravir (Tivicay) with or without food?
    Can be administered without regard to food
  126. What should patients on Dolutegravir (Tivicay) avoid?
    • Avoid cation containing meds: mg, Ca supplements, iron, sucralfate, antacids
    • Anticonvulsants: phenytoin, phenobarbital, carbamazepine,
  127. What are the Side effects of Dolutegravir (Tivicay)?
    • Insomnia, headache
    • Hypersensitivity reactions (rash)
    • Worsening or elevated LFTs
  128. What does Stribild contain?
    • Tenofovir, emtricitabine – NRTIs
    • Elvitegravir – integrase inhibitor
    • Cobicistat – novel P450 inhibitor (no activity against HIV)
  129. What patients are eligible to receive Stribild (Tenofovir, emtricitabine, Eltegravir and Cobicistat)?
    • Used for tx-naïve patients
    • Only in patients with CrCl > 70 ml/min
  130. What is the dose of Stribild (Tenofovir, emtricitabine, Eltegravir and Cobicistat)?
    1 tab QD
  131. Cobicistat is FDA approved to be given with what other drugs?
    FDA approved to be given with atazanavir or darunavir
  132. What type of drug is Cobicistat?
    P450 inhibitor
  133. Elvitegravir comes in what dosage sizes?
    85 & 150 mg tablets
  134. How is Elvitegravir used?
    With boosted PI + another drug (NRTI)
  135. What is the most common side effect of Elvitegravir?
    Diarrhea (7%)
  136. What is EC90?
    Concentration of drug that are needed to inhibit 90% of the viral growth
  137. A resistant virus EC90 compared to a wild-type virus is many times lower or higher?
    Higher
  138. Phenotypic resistance is the consequence of____________________________________.
    Specific mutations in target genes
  139. Combination regimens with enhanced antiviral potency suggests that the emergence of resistance is reduced when____________________________.
    viral replication is effectively suppressed
  140. What is the most common reason for resistance to develop to HIV drugs?
    • Non-adherence
    • (Make regimens doable)
  141. What is “Viral load”?
    • Number of RNA copies in the serum
    • Indirect reflection of the number productively infected cells
    • associated with the rate of disease progression and time of death
  142. HIV RNA viral load or CD4 counts are more predictive of disease progression?
    RNA viral load
  143. Typically ____________ virions are produced daily.
    10^9 to 10^10
  144. When What is HIV RNA assay used for?
    • Assessing baseline status in newly diagnosed
    • Assessing response to therapy
    • Assessing development of resistance to current therapy
  145. What are the benefits of Combination therapy for HIV?
    Reduced toxicity and emergence of resistance
  146. The minimal change in viral load considered to be statistically significant is:
    A threefold or 0.5 log copies/mL change
  147. Optimal viral suppression is generally defied as a viral load below the level of detection, what is the level of detection?
    < 200 copies/mL
  148. How long does it take for an antiviral regimen to produce viral suppression?
    Achieved in 12-24 weeks
  149. Didanosine is not recommended as initial therapy due to:
    Aadverse rxns
  150. What are the SE of Didanosine?
    • Pancreatitis (+ D4T); peripheral neuropathy; nausea; diarrhea;
    • lactic acidosis (rare but life threatening – NRTIs class effect)
  151. What NTRIs can cause Lactic acidosis?
    All
  152. Is Emtricitabine used for initial therapy?
    Yes
  153. Does Emitricitabine effected by food consumption?
    No food effect
  154. Does Emtricitabine have poor or good Bioavailability?
    Good (93%)
  155. What drugs should Emtricitabine not be used with?
    Lamivudine (3TC) – Too similar
  156. What are the SE of Emtricitabine?
    • Toxicity – minimal
    • HA, N/V, diarrhea – occasionally
    • Lactic acidosis with hepatic steatosis
  157. Lamivudine has what bioavailability and T ½?
    • Bioavail = 86%
    • T1/2intra=18-22 hrs
  158. What is Lamivudine also used to treat?
    Hepatitis B
  159. What are the SE of Lamivudine?
    Toxicity – lactic acidosis
  160. When would you use Stavudine?
    • Rarely
    • Not recommended by DHHS due to side effects
  161. How is Stavudine excreted?
    Renal excretion -50%
  162. What are eth SE of Stavidine?
    • Toxicity: lipodystrophy (highest incidence); hyperlipidemia; lactic acidosis
    • Do not use D4T + ddI together (CIPregnancy)
  163. Is Tenofovir recommended for initial therapy?
    Yes
  164. How is Tenofovir excreted?
    Renal excretion
  165. What are the SE of Tenofovir?
    Toxicity: headache; N/V; diarrhea; renal insuff; lactic acidosis
  166. Is Tenofovir used very much?
    Yes
  167. Zidovudine is metabolized how?
    • In liver
    • Glucuronidation
  168. What are the SE of Zidovudine?
    Toxicity: bone marrow suppression (CI Hgb < 8); GI intolerance; insomnia; lactic acidosis
  169. Are protease inhibitors usually used alone?
    No often boosted with Ritonavir
  170. How are most PI metabolized?
    CYP3A
  171. When you give Ritonavir with PIs what activity are you using it for?
    Inhibit metabolism of the PI (not used as an antiretroviral)
  172. PI inhibitors should be taken with or without food?
    With a moderate to high fat meal (eggs/bacon/sausage/gravy)
  173. What are the protease inhibitors?
    • Indinavir - Crixivan
    • Nelfinavir - Viracept
    • Ritonavir – Norvir
    • Lopinavir/Ritonavir – Kaletra
    • Fosamprenavir - Lexiva
    • Atazanavir – Reyataz
    • Tipranavir – Aptivus
    • Darunavir – Prezista
  174. What is the brand name for Indinavir?
    Crixivan
  175. What is the brand name for Nelfinavir ?
    Viracept
  176. What is the brand name for Ritonavir?
    Norvir
  177. What is the brand name for Lopinavir/Ritonavir?
    Kaletra
  178. What is the brand name for Fosamprenavir?
    Lexiva
  179. What is the brand name for Atazanavir?
    Reyataz
  180. What is the brand name for Tipranavir?
    Aptivus
  181. What is the brand name for Darunavir?
    Prezista
  182. What is the generic name for Crixivan?
    Indinavir
  183. What is the generic name for Viracept?
    Nelfinavir
  184. What is the generic name for Norvir?
    Ritonavir
  185. What is the generic name for Kaletra?
    Lopinavir/Ritonavir
  186. What is the generic name for Lexiva?
    Atazanavir
  187. What is the generic name for Reyataz?
    Fosamprenavir
  188. What is the generic name for Aptivus?
    Tipranavir
  189. What is the generic name for Prezista?
    Darunavir
  190. What type of drug is Indinavir – Crixivan?
    PI
  191. What type of drug is Nelfinavir - Viracept?
    PI
  192. What type of drug is Raltegravir – Isentress ?
    Integrase inhibitor
  193. What type of drug is Dolutegravir – Tivicay?
    Integrase inhibitor
  194. What type of drug is Dolutegravir abacavir/lamivudine – Triumeq?
    Integrase inhibitor
  195. What type of drug is Elvitegravir – Stribild (quad pill)?
    Integrase inhibitor
  196. What type of drug is Cobicistat – Tybost ?
    Integrase inhibitor/Enzyme inhibitor for p450 system ?
  197. What type of drug is Elvitegravir – Vitekta?
    Integrase inhibitor
  198. What type of drug is Ritonavir – Norvir?
    PI
  199. What type of drug is Lopinavir/Ritonavir – Kaletra?
    PI
  200. What type of drug is Fosamprenavir - Lexiva?
    PI
  201. What type of drug is Atazanavir – Reyataz?
    PI
  202. What type of drug is Tipranavir – Aptivus?
    PI
  203. What type of drug is Darunavir – Prezista?
    PI
  204. What type of drug is Zidovudine – Retrovir?
    NRTI
  205. What type of drug is Didanosine - Videx?
    NRTI
  206. What type of drug is Lamivudine - Epivir?
    NRTI
  207. What type of drug is Stavudine - Zerit?
    NRTI
  208. What type of drug is Abacavir - Ziagen?
    NRTI
  209. What type of drug is Tenofovir-Viread?
    NRTI
  210. What can be used for prophylaxis for heterosexual transmission of HIV-1?
    1% tenofovir gel
  211. What is used for prophylaxis for MSM transmission of HIV-1?
    Truvada QD
  212. Most opportunistic infections occur when CD4+ cells have fallen to what level?
    < 200/mm3
  213. How is acute Pneumocystis jerovici pneumonia (PCP) (Protozoal infection of the lungs) treated in AIDS?
    • DOC: TMP-SMZ for 21 days (DOC)
    • Alternative: Pentamidine if rash develops with Bactrim
    • Prophylaxis - TMP-SMZ 1 DS or SS qd for life
  214. What is the MOA of Bactrim?
    • Sulfamethoxazole: Inhibits dihydrofolate formation from PABA, thus interfering with bacterial folic acid synthesis and growth
    • Trimethoprim: inhibits dihydrofolate reduction to tetrahydrofolate
  215. What is the Spectrum for Bactrim?
    • G(+): MSSA, MRSA, Strep, Listeria
    • G(-): Enterobacteriaceae, E. coli, H. influenzae, Stenotrophomonas
    • Does not cover: Pseudomonas
    • Other organisms: Pneumocystis jiroveci, Nocardia, Toxoplasma, Legionella
  216. Toxoplasmic encephalitis is a Protozoan parasite that usually invades CNS in AIDS patients, what is the treatment?
    • Pyrimethamine QD + sulfadiazine QID for 6-12 weeks
    • OR
    • clindamycin + pyrimethamine
    • OR
    • Atovaquone
  217. How do you prophylax for Toxoplasmic encephalitis?
    • 1st choice: PCP prophylaxis with Bactrim
    • Alternative: dapsone + pyrimethamine
  218. How do you treat TB in HIV patients?
    Isoniazid + pyridoxine QD x 12 months
  219. What is the Prophylaxis regimen for M. avis (MAC)?
    • 1st choice: clarithromycin BID or azithromycin Qw
    • Clarithro has P450 DDIs, so go for Azithro first
  220. What is the Candidiasis prophylaxis regimen?
    • 1st choice: fluconazole
    • alternative: itraconzole
    • voriconazole
    • posoconazole
  221. Cryptosporidiosis is a Protozoan parasite that causes mild to intractable diarrhea in AIDS patients, how is it managed?
    • fluid therapy
    • nutritional support
    • anti diarrheals
    • Nitazoxanide FDA approved
    • octreotide (Sandostatin) may control severe diarrhea
    • Usually NPO
  222. What is the Histoplasmosis Prophylaxis regimen?
    • itraconazole
    • must have an acid environment to absorbed this drug (Diet soda)
    • Posaconazole – alternative option
    • Must take with food for absorption
  223. How do you treat Cytomegalovirus (CMV) in HIV?
    • Ganciclovir or foscarnet
    • Alternatives:
    • Oral valganciclovir
    • Cidofovir – hard on kidneys so try to avoid
  224. HSV is treated with what drug in HIV?
    Acyclovir
  225. What are the risk factors for HIV?
    • Homosexual/bisexual men
    • IV drug use/abuse
    • sex partners in abuse groups
    • heterosexual men and women
    • Infants of above groups
  226. What are the Symptoms of HIV?
    • Fatigue/malaise
    • Lymphadenopathy
    • Weight loss
    • Fever
    • Night sweats
    • Diarrhea
    • Sore throat
  227. What labs indicate HIV?
    • CBC - decrease in WBC; decrease in H/H; decrease in platelets (slight)
    • T-cells subsets - prognostic valve (indirect)
    • T-helper (CD4) count (<500)
    • Skin-test anergy (can’t mount an immune response if they get a skin test of some sort)
    • Virology:
    • ELISA IgM or ELISA/Ag (Quick screening test)
    • Western blot – if negative - perform HIV viral load
  228. What drug is used to prevent HIV infection in high risk individuals?
    Truvada
  229. How do you prevent an HIV infection after an errant needle stick?
    • Decide whether to get treatment
    • Wash wound
    • Treatment (prophylaxis) - start ASAP (within 2 h)
    • Lasts 6 months if ELSIAs are all negative
    • ELISA - 0, 6 wks, 3 & 6 months
  230. What are the Nucleoside reverse transcriptase inhibitors?
    • Zidovudine - Retrovir
    • Didanosine - Videx
    • Lamivudine - Epivir
    • Stavudine - Zerit
    • Abacavir - Ziagen
    • Tenofovir-Viread
    • Emtricitabine-Emtriva
    • Abacavir+Lamivudine - Epzicom
    • Emtricitabine+Tenofovir DF – Truvada
    • Lamivudine+Zidovudine – Combivir
  231. What is the brand name for Zidovudine?
    Retrovir
  232. What is the brand name for Lamivudine?
    Epivir
  233. What is the brand name for Stavudine?
    Zerit
  234. What is the brand name for Tenofovir?
    Viread
  235. What is the brand name for Abacavir?
    Ziagen
  236. What is the brand name for Didanosine?
    Videx
  237. What is the brand name for Emtricitabine?
    Emtriva
  238. What is the brand name for Abacavir+Lamivudine?
    Epzicom
  239. What is the brand name for Emtricitabine+Tenofovir DF?
    Truvada
  240. What is the brand name for Lamivudine+Zidovudine?
    Combivir
  241. Nuceoside reverse transcriptase inhibitors need what to happen before they are active?
    Phosphorylation process (tri or di phosphorylation)
  242. What is the MOA of Nucleoside Reverse Transcriptase inhibitors?
    • Similar to Purines and Pyrimidines
    • Integrated in replication chain
    • Stop reverse transcriptase from replicating the DNA strand
    • Prevent formation of new virions
  243. What is the generic name for Retrovir?
    Zidovudine
  244. What is the generic name for Epivir?
    Lamivudine
  245. What is the generic name for Zerit?
    Stavudine
  246. What is the generic name for Ziagen?
    Abacavir
  247. What is the generic name for Viread?
    Tenofovir
  248. What is the generic name for Videx?
    Didanosine
  249. What is the generic name for Emtriva?
    Emtricitabine
  250. What is the generic name for Epzicom?
    Abacavir+Lamivudine
  251. What is the generic name for Truvada?
    Emtricitabine+Tenofovir DF
  252. What is the generic name for Combivir?
    Lamivudine+Zidovudine
  253. How often is Abacavir (ABC) given?
    BID or QD
  254. What is Abacavir metabolized by?
    • EtOH dehydrogenase
    • EtOH leads to elevated ABC
  255. What are the major risks of taking Abacavir?
    • Cardiac events
    • Potentially fatal hypersensitivity reactions (Fever/Rash/N/V, Anorexia, SOB, cough, sore throat)
  256. How can you avoid Hypersensitivity reactions associated with Abacavir?
    • Screen for HLA B*5701
    • Homozygous + or Heterozygous + are likely to have a hypersensitivity rxn
    • 100% positive predictive value for the rxn
  257. What combination therapy should be avoided with Abacavir?
    TDF (Tenofovir)

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